Application of Noninvasive Positive Pressure Ventilation in Patients with Acute Left Heart Failure_West China Medical Journal

Authors：

 LiuXiaoyi , ZhengXiangde , LiuHui

Department of Critical Care Medicine, the Central Hospital of Dazhou, Dazhou, Sichuan 635000, P. R. China;

Corresponding?author：

Keywords：

Noninvasive positive pressure ventilation; Acute left heart failure; Mechanical ventilation; Cardiogenic pulmonary edema

DOI：

10.7507/1002-0179.201600179

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Objective To investigate the effects of noninvasive positive pressure ventilation (NPPV) on patients with acute left heart failure. Methods Twenty patients with acute left heart failure diagnosed between September 2013 and July 2014 were randomized into treatment group (n=10) and control group (n=10). Both groups used conventional sedations, diuretics and drugs that strengthened the heart and dilated the vessels, while early use of NPPV was applied in the experimental group. Arterial blood gas analysis [pH value, pressure of arterial carbon dioxide (PaCO₂), and pressure of arterial oxygen (PaO₂)], heart rate (HR), respiration, duration of Intensive Care Unit (ICU) stay and invasive mechanical ventilation, duration of overall mechanical ventilation, and success case numbers before and two hours after treatment were observed and analyzed. Results For the control group, two hours after treatment, PaO₂ was (67.0±8.5) mm Hg (1 mm Hg=0.133 kPa), HR was (124±10) times/min, Respiration was (34±4) times/min, the duration of ICU stay was (6.0±1.1) days, invasive ventilation was for (32.0±3.1) hours, and the total time of mechanical ventilation was (32.0±3.1) hours. Those indexes for the treatment group two hours after treatment were: PaO₂, (82.3±8.9) mm Hg; HR, (98±11) times/min; respiration, (24±4) times/min; the duration of ICU stay, (4.0±0.8) days; invasive ventilation time, (16.0±1.3) hours; the total time of mechanical ventilation, (26.0±1.8) hours. All the differences for each index between the two groups were statistically significant (P < 0.05). Conclusion Early application of NPPV can rapidly relieve clinical symptoms and reduce the medical cost for patients with acute left heart failure.

Citation： LiuXiaoyi, ZhengXiangde, LiuHui. Application of Noninvasive Positive Pressure Ventilation in Patients with Acute Left Heart Failure. West China Medical Journal, 2016, 31(4): 650-652. doi: 10.7507/1002-0179.201600179 Copy

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1. ?中華醫學會心血管病學分會. 急性心力衰竭診斷和治療指南[J].中華心血管病雜志, 2010, 38(3): 195-208.
2. 崔錦女. 急性心源性肺水腫患者的護理體會[J].中國保健營養: 中旬刊, 2014, 24(5): 3069.
3. 胡秀容. 急性左心衰136臨床分析[J]. 中國衛生產業, 2013, (27): 15-17.
4. 尹代雙. 60例急性左心衰的發病誘因及臨床治療觀察[J]. 心血管病防治知識, 2013, (6): 38-39.
5. 周運東. 老年急性左心衰的臨床特點及治療對策探討[J]. 齊齊哈爾醫學院學報, 2014, 35(9): 1318-1319.
6. 李雪梅. 急性左心衰患者救治的臨床療效觀察[J]. 貴陽中醫學院學報, 2013, 35(3): 96-98.
7. 彭海軍. 烏拉地爾聯合硝酸甘油治療急性左心衰伴高血壓的療效觀察[J]. 現代診斷與治療, 2013, 24(8): 1879-1880.
8. 王輝華. 硝普鈉治療急性左心衰竭的臨床效果分析[J]. 中國醫藥科學, 2013, 3(2): 73-74.
9. 吳華容. 磷酸肌酸鈉治療急性左心衰的療效觀察[J]. 齊齊哈爾醫學院學報, 2013, 34(10): 1450-1451.
10. 王勝文, 李莉紅, 王慧慧. 呼吸機治療急性左心衰36例臨床分析[J]. 中國實用醫藥, 2013, 8(5): 126-127.
11. 周朝霞. 急性左心衰的健康指導[J]. 中國社區醫師: 醫學專業, 2012, 14(6): 381-381.
12. 牛春燕. 強心利尿擴血管藥物治療心力衰竭的體會[J]. 醫學信息, 2011, 24(9): 5818-5819.
13. 劉小毅, 鄭祥德, 吳昌徽. 嚴重心功能不全致呼吸機依賴患者成功脫機一例[J]. 華西醫學, 2013, 28(12): 1964.
14. 陳亞利, 霍敏琴, 楊梅. 無創正壓通氣在治療急性左心衰中的應用價值研究[J]. 中國實用內科雜志, 2005, 25(5): 428-430.
15. 馮玉璽. 無創持續正壓通氣治療急性心源性肺水腫[J]. 醫學綜述, 2008, 14(14): 2141-2143.
16. 馮春微, 許少輝, 廖靜, 等. 無創呼吸機通氣治療急性左心衰23例的臨床分析[J]. 現代預防醫學, 2011, 38(16): 3357-3359.
17. 陳鋒, 劉景峰, 張萬義. 無創機械通氣對重度急性左心衰療效觀察[J]. 河北醫學, 2014, 36(16): 2437-2439.

West China Medical Journal

Application of Noninvasive Positive Pressure Ventilation in Patients with Acute Left Heart Failure

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